Provider Demographics
NPI:1932277795
Name:COMMUNITY AMBULANCE SERVICE FOR NORTHERN DES MOINES COUNTY
Entity Type:Organization
Organization Name:COMMUNITY AMBULANCE SERVICE FOR NORTHERN DES MOINES COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GERLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-394-3440
Mailing Address - Street 1:412 MAIN ST.
Mailing Address - Street 2:BOX 400
Mailing Address - City:MEDIAPOLIS
Mailing Address - State:IA
Mailing Address - Zip Code:52637-0400
Mailing Address - Country:US
Mailing Address - Phone:319-394-3440
Mailing Address - Fax:319-394-3440
Practice Address - Street 1:412 MAIN ST.
Practice Address - Street 2:
Practice Address - City:MEDIAPOLIS
Practice Address - State:IA
Practice Address - Zip Code:52637-0400
Practice Address - Country:US
Practice Address - Phone:319-394-3440
Practice Address - Fax:319-394-3440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA22904003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0180844Medicaid
IA0180844Medicaid